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KMID : 1035520190070010001
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Brain Tumor Research and Treatment : BTRT
2019 Volume.7 No. 1 p.1 ~ p.9
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The Korean Society for Neuro-Oncology (KSNO) Guideline for Glioblastomas: Version 2018.01
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Kim Young-Zoon
Kim Chae-Yong
Lim Jae-Joon
Sung Kyoung-Su
Lee Ji-Hae
Oh Hyuk-Jin
Kang Seok-Gu
Kang Shin-Hyuk
Kong Doo-Sik
Kim Sung-Hwan
Kim Se-Hyuk
Kim Se-Hoon
Kim Yu-Jung
Kim Eui-Hyun
Kim In-Ah
Kim Ho-Sung
Roh Tae-Hoon
Park Jae-Sung
Park Hyun-Jin
Song Sang-Woo
Yang Seung-Ho
Yoon Wan-Soo
Yoon Hong-In
Lee Soon-Tae
Lee Sea-Won
Lee Youn-Soo
Wee Chan-Woo
Chang Jong-Hee
Jung Tae-Young
Jung Hye-Lim
Cho Jae-Ho
Choi Seung-Hong
Choi Hyoung-Soo
Hong Je-Beom
Lim Do-Hoon
Chung Dong-Sup
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Abstract
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Background: There has been no practical guidelines for the management of patients with central nervous system (CNS) tumors in Korea for many years. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, started to prepare guidelines for CNS tumors from February 2018.
Methods: The Working Group was composed of 35 multidisciplinary medical experts in Korea. References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of keywords.
Results: First, the maximal safe resection if feasible is recommended. After the diagnosis of a glioblastoma with neurosurgical intervention, patients aged ≤70 years with good performance should be treated by concurrent chemoradiotherapy with temozolomide followed by adjuvant temozolomide chemotherapy (Stupp's protocol) or standard brain radiotherapy alone. However, those with poor performance should be treated by hypofractionated brain radiotherapy (preferred)±concurrent or adjuvant temozolomide, temozolomide alone (Level III), or supportive treatment. Alternatively, patients aged >70 years with good performance should be treated by hypofractionated brain radiotherapy+concurrent and adjuvant temozolomide or Stupp's protocol or hypofractionated brain radiotherapy alone, while those with poor performance should be treated by hypofractionated brain radiotherapy alone or temozolomide chemotherapy if the patient has methylated MGMT gene promoter (Level III), or supportive treatment.
Conclusion: The KSNO's guideline recommends that glioblastomas should be treated by maximal safe resection, if feasible, followed by radiotherapy and/or chemotherapy according to the individual comprehensive condition of the patient.
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KEYWORD
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Korean Society for Neuro-Oncology, Guideline, Glioblastomas, Practice
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